| Code | Description | Claims | Beneficiaries | Total Paid |
|---|
| 99213 |
Office or other outpatient visit for the evaluation and management of an established patient, low complexity |
424 |
417 |
$74K |
| 99214 |
Office or other outpatient visit for the evaluation and management of an established patient, moderate complexity |
48 |
46 |
$8K |
| 99392 |
Periodic comprehensive preventive medicine reevaluation, established patient, early childhood (1-4 years) |
16 |
16 |
$3K |
| 99393 |
Periodic comprehensive preventive medicine reevaluation, established patient, late childhood (5-11 years) |
14 |
14 |
$2K |
| 99391 |
Periodic comprehensive preventive medicine reevaluation, established patient, infant (under 1 year) |
13 |
13 |
$2K |
| 99051 |
|
19 |
19 |
$213.75 |
| 90460 |
Immunization administration through 18 years of age via any route, first or only component |
270 |
266 |
$63.05 |
| 96127 |
|
113 |
105 |
$42.66 |
| 90686 |
|
104 |
104 |
$16.42 |
| 96110 |
Developmental screening, with scoring and documentation, per standardized instrument |
35 |
35 |
$0.00 |
| 90723 |
|
12 |
12 |
$0.00 |
| 85018 |
|
12 |
12 |
$0.00 |
| 90670 |
|
21 |
21 |
$0.00 |
| 99173 |
|
79 |
79 |
$0.00 |
| 81003 |
|
59 |
58 |
$0.00 |
| 87804 |
Infectious agent antigen detection by immunoassay; Influenza, each type |
26 |
26 |
$0.00 |
| 90461 |
|
96 |
96 |
$0.00 |